Zhang CaiYan, Guo ZiHong, Yi ChunXiu, Wang Han, Zhang Wen, Zhao YaJing
Department of Hypertension, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences/ Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China.
J Hum Hypertens. 2025 Jul 16. doi: 10.1038/s41371-025-01006-8.
Measurements of renin and aldosterone are important for the diagnosis and treatment of different renin sub-types of hypertension as well as endocrine hypertension, particularly primary aldosteronism (PA). However, numerous factors can influence the measurements of renin and aldosterone, including geographical location, ethnicity, body posture, dietary habits, sex, and age, instrumentation, methodology. This study aimed to establish age- and sex-specific reference intervals for renin and aldosterone in Yunnan Province, China. This study was a cross-sectional survey conducted in Yunnan Province, China, using multi-stage stratified random sampling method from four districts/counties and urban and rural settings. Age, gender, medical history, medication history and family history of the individuals were first collected, then height, weight, blood pressure and heart rate were measured and blood specimens were collected to test biochemical parameters, plasma renin concentration (PRC) and plasma aldosterone concentration (PAC). During the selection process, we first excluded individuals with obvious clinical symptoms and diagnosed diseases, and selected 9129 ostensibly healthy as the initial sample. Next, we excluded participants who were in pregnancy, lactating, taking contraceptive, hypertension, hypokalemia, renal insufficiency, obesity, and finally successfully included 5200 individuals. A rigorous statistical analysis was conducted to investigate differences in renin and aldosterone levels by sex and age, facilitating the redefinition of groups, and subsequently, reference intervals for renin and aldosterone were established within the redefined groups. Renin and aldosterone levels differed significantly across sex and age groups. Specifically, PRC was significantly lower in women than men, while PAC was significantly higher in men than women. PRC decreased with age, while PAC levels were lowest in the 18-24 age group and peaked in the 25-64 age group. Our findings underscore the crucial role of sex and age when precisely evaluating renin and aldosterone levels. This study established, for the first time, age- and sex-specific reference intervals for renin and aldosterone in healthy individuals in Yunnan Province, China. These findings may provide some guidance for the diagnosis and treatment of different renin sub-types of hypertension, as well as some help in providing new ideas for further research on PA.
肾素和醛固酮的测定对于不同肾素亚型高血压以及内分泌性高血压，尤其是原发性醛固酮增多症（PA）的诊断和治疗至关重要。然而，许多因素会影响肾素和醛固酮的测定，包括地理位置、种族、身体姿势、饮食习惯、性别、年龄、仪器设备、方法学等。本研究旨在建立中国云南省肾素和醛固酮的年龄及性别特异性参考区间。本研究是在中国云南省进行的一项横断面调查，采用多阶段分层随机抽样方法，选取了四个区县以及城乡地区。首先收集个体的年龄、性别、病史、用药史和家族史，然后测量身高、体重、血压和心率，并采集血标本检测生化参数、血浆肾素浓度（PRC）和血浆醛固酮浓度（PAC）。在筛选过程中，我们首先排除有明显临床症状和已确诊疾病的个体，选取9129名表面健康者作为初始样本。接下来，我们排除了怀孕、哺乳期、服用避孕药、高血压、低钾血症、肾功能不全、肥胖的参与者，最终成功纳入5200名个体。进行了严格的统计分析，以研究肾素和醛固酮水平在性别和年龄上的差异，便于重新分组，随后在重新定义的组内建立肾素和醛固酮的参考区间。肾素和醛固酮水平在性别和年龄组之间存在显著差异。具体而言，女性的PRC显著低于男性，而男性的PAC显著高于女性。PRC随年龄增长而降低，而PAC水平在18 - 24岁年龄组最低，在25 - 64岁年龄组达到峰值。我们的研究结果强调了性别和年龄在精确评估肾素和醛固酮水平时的关键作用。本研究首次在中国云南省健康个体中建立了肾素和醛固酮的年龄及性别特异性参考区间。这些发现可能为不同肾素亚型高血压的诊断和治疗提供一些指导，也有助于为PA的进一步研究提供新思路。
